Dimensions of lay health worker programmes: results of a scoping study and production of a descriptive framework

South, Jane; Meah, Angela; Bagnall, Anne‐Marie; Rs, Jones

doi:10.1177/1757975912464248

Cited by 30 publications

(38 citation statements)

References 33 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… LMIC low- and middle-income country, HIC high-income country *CHW program scale up [ 23 ]; CHW program integration [ 38 ]; peer telephone calls for multiple health issues [ 69 ]; intervention design factors that influence CHW performance [ 15 ]; role of allied health assistants in the health system [ 70 , 71 ]; the dimensions of lay health worker programs [ 13 ] **Two articles on maternal mental health are classified under maternal health [ 72 , 73 ] # One review on pediatric chronic disease had no regional focus and included only non-communicable chronic diseases (asthma, diabetes, obesity and failure to thrive) [ 56 ]; another review was specific to childhood asthma [ 57 ]; one study on adult chronic disease in South Africa primarily dealt with HIV, so is classified under “HIV”, but we note that five of the 29 articles in that review were on mental health [ 74 ] ## For one review (on CHWs for palliative care) [ 75 ], no articles met the inclusion criteria but the search included LMICs and HICs …”

Section: Resultsmentioning

confidence: 99%

“…*CHW program scale up [ 23 ]; CHW program integration [ 38 ]; peer telephone calls for multiple health issues [ 69 ]; intervention design factors that influence CHW performance [ 15 ]; role of allied health assistants in the health system [ 70 , 71 ]; the dimensions of lay health worker programs [ 13 ]…”

Section: Resultsmentioning

confidence: 99%

“…The number, complexity, and range of functions CHWs perform vary substantially among programs according to context-specific needs and opportunities; functions also evolve over time [ 13 ]. While there is no optimal set of tasks or workload level that maximizes CHW productivity, one review [ 14 ] cited studies that found that too many responsibilities reduce CHW productivity and service quality, and CHWs in these situations are forced to choose which tasks to perform based on factors such as feasibility, remuneration, or preference.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

Scott

Beckham

Gross³

et al. 2018

Hum Resour Health

428

439

View full text Add to dashboard Cite

ObjectiveTo synthesize current understanding of how community-based health worker (CHW) programs can best be designed and operated in health systems.MethodsWe searched 11 databases for review articles published between 1 January 2005 and 15 June 2017. Review articles on CHWs, defined as non-professional paid or volunteer health workers based in communities, with less than 2 years of training, were included. We assessed the methodological quality of the reviews according to AMSTAR criteria, and we report our findings based on PRISMA standards.FindingsWe identified 122 reviews (75 systematic reviews, of which 34 are meta-analyses, and 47 non-systematic reviews). Eighty-three of the included reviews were from low- and middle-income countries, 29 were from high-income countries, and 10 were global. CHW programs included in these reviews are diverse in interventions provided, selection and training of CHWs, supervision, remuneration, and integration into the health system. Features that enable positive CHW program outcomes include community embeddedness (whereby community members have a sense of ownership of the program and positive relationships with the CHW), supportive supervision, continuous education, and adequate logistical support and supplies. Effective integration of CHW programs into health systems can bolster program sustainability and credibility, clarify CHW roles, and foster collaboration between CHWs and higher-level health system actors. We found gaps in the review evidence, including on the rights and needs of CHWs, on effective approaches to training and supervision, on CHWs as community change agents, and on the influence of health system decentralization, social accountability, and governance.ConclusionEvidence concerning CHW program effectiveness can help policymakers identify a range of options to consider. However, this evidence needs to be contextualized and adapted in different contexts to inform policy and practice. Advancing the evidence base with context-specific elements will be vital to helping these programs achieve their full potential.Electronic supplementary materialThe online version of this article (10.1186/s12960-018-0304-x) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

Scott

Beckham

Gross³

et al. 2018

Hum Resour Health

428

439

View full text Add to dashboard Cite

show abstract

“…Evidence suggests that the presence of community health workers (CHWs) can complement an overstretched health workforce and may be key to increasing the availability of, and access to, basic health services especially in hard-to-reach areas, thereby bridging the health equity gap [ 4 , 5 ]. However, the diversity of roles and inconsistent nomenclature of CHWs make it difficult for policy makers, programme planners, and researchers working with CHWs in different settings to have a common understanding of ‘who is a CHW?’ [ 6 ]. Furthermore, in contrast to professional health workers, there is remarkable diversity in the content and duration of CHWs’ training.…”

Section: Introductionmentioning

confidence: 99%

Who is a community health worker? – a systematic review of definitions

Olaniran

Smith

Unkels

et al. 2017

Global Health Action

254

207

View full text Add to dashboard Cite

Background: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. Objective: To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers. Design: A systematic review of peer-reviewed papers and grey literature. Results: We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. CHWs can be categorised into three groups by education and pre-service training. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried. Conclusions: This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research.

show abstract

“…Link workers (lay health workers, health support workers) based in the community provide additional support to individuals and families to facilitate engagement with primary care and other services and resources [ 1 ]. This additional support aims to tackle the wider socio-economic determinants of health that lead to inequalities.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of Dental Health Support Workers at linking families with primary care dental practices: a population-wide data linkage cohort study

et al. 2018

View full text Add to dashboard Cite

BackgroundLink workers (lay health workers, health support workers) based in the community provide additional support to individuals and families to facilitate engagement with primary care and other services and resources. This additional support aims to tackle the wider socio-economic determinants of health that lead to inequalities. To date, there is no clear evidence of the effectiveness of these programmes. This study evaluates the effectiveness of Dental Health Support Workers (DHSW) at linking targeted families with young children to primary care dental practices. The DHSW role is one component of Childsmile, the national oral health improvement programme in Scotland.MethodsA quasi-experimental approach captured the natural variation in the rollout of the DHSW intervention across Scotland in a cohort of children born between 2010 and 2013. Survival analysis explored “time to attendance” at primary care dental practice. Cox’s regression models compared attendance rates and time until first attendance between those families who received support from the DHSW and those who did not.ResultsThe cohort consisted of 35236 children. Thirty-three percent of the cohort (n = 11495) were considered to require additional support from a DHSW. Of these, 44% (5087) received that support. These families were more likely to attend a dental practice (Hazard Ratio [95% Confidence Interval] =1.87 [1.8 to 1.9]) and, on average, did so 9 months earlier (median time until first attendance: 8.8 months versus 17.8 months), compared to families not receiving additional support.ConclusionsLink workers (DHSW) within the Childsmile programme are effective at linking targeted children to primary care dental services and, most notably, at a younger age for prevention. This is the first study of its kind to evaluate the effectiveness of link-worker programmes using a robust quasi-experimental design on three, population-wide, linked datasets. These results will inform future health programmes which aim to improve health and reduce inequalities by reaching and supporting families from more disadvantaged backgrounds.

show abstract

Dimensions of lay health worker programmes: results of a scoping study and production of a descriptive framework

Cited by 30 publications

References 33 publications

What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

Who is a community health worker? – a systematic review of definitions

The effectiveness of Dental Health Support Workers at linking families with primary care dental practices: a population-wide data linkage cohort study

Contact Info

Product

Resources

About